Ethnicity, desirable responding, and self-reports of abuse: a comparison of European- and Asian-ancestry undergraduates.

One thousand fifty-two (582 non-Asian, 470 Asian) university students were assessed regarding levels of physical abuse, emotional abuse, sexual abuse, neglect, and socially desirable responding. Differences between Asian-ancestry and European-ancestry students in self-reported incidence and expression of abuse were evaluated, as was gender and the relation between self-reported abuse and socially desirable responding. Asian-ancestry men and women reported higher levels of physical abuse, emotional abuse, and neglect than did their Euro-ancestry counterparts, and Euro-ancestry women reported a higher incidence of sexual abuse than did Asian-ancestry women. Across ethnicity, men reported higher levels of physical abuse and neglect but lower levels of sexual abuse than did women. Socially desirable responding was not related to measures of abuse. Findings are discussed in terms of cultural influences on child-rearing and disciplinary practices.

Virtual reality and tactile augmentation in the treatment of spider phobia: a case report.

This is the first case report to demonstrate the efficacy of immersive computer-generated virtual reality (VR) and mixed reality (touching real objects which patients also saw in VR) for the treatment of spider phobia. The subject was a 37-yr-old female with severe and incapacitating fear of spiders. Twelve weekly 1-hr sessions were conducted over a 3-month period. Outcome was assessed on measures of anxiety, avoidance, and changes in behavior toward real spiders. VR graded exposure therapy was successful for reducing fear of spiders providing converging evidence for a growing literature showing the effectiveness of VR as a new medium for exposure therapy.

Screening for maternal experiences of physical abuse during childhood.

Because a parental history of abuse during childhood is a documented risk factor for child abuse, pediatricians have been urged to assess parents' childhood discipline experiences. A brief set of questions was developed to detect a maternal history of childhood physical abuse that could be incorporated into a comprehensive psychosocial screening questionnaire. A criterion-based definition was used as the measure for physical abuse. In phase I, four screening questions were developed in a cross-sectional survey of 284 middle-class women attending a family medicine clinic, of whom 32% met the criteria definition for physical abuse. In phase II, the screening questions were tested in 428 mothers seen in Salt Lake City- and Seattle-area pediatric clinics. The four screening questions had a sensitivity of > 90%, a specificity of > 85%, a positive predictive value of > 75%, and a negative predictive value of > or = 90%--as compared with the criteria-based definition in both pediatric settings. These four screening questions compared favorably to a criteria-based definition of physical abuse during childhood and may be useful additions to psychosocial questionnaires.

The effect of differences in objective and subjective definitions of childhood physical abuse on estimates of its incidence and relationship to psychopathology.

The relationship between objective and subjective definitions of physical abuse and the lifetime prevalence of depression was examined in 280 women attending a family medicine clinic at a large medical center. Based on their responses to a detailed questionnaire regarding discipline and abuse in childhood, 28.2% of these women were objectively defined as abused. Only 11.4% subjectively defined themselves as abused. The proportion of women who experienced depression during their lifetime was highest among those who defined themselves as abused (83%), intermediate among those who met objective criteria for having been physically abused, but did not define themselves as such (56%), and lowest among those who did not meet objective criteria for a history of physical abuse (35%). Similar relationships were found for history of psychotherapy, receipt of psychoactive medication, history of hospitalization for depression, suicide attempts and self-injury.

Self-reported childhood abuse in an adult population in a primary care setting. Prevalence, correlates, and associated suicide attempts.

OBJECTIVE: To describe the prevalence of childhood physical, sexual, and emotional abuse and suicide attempts in a sample of adult patients from a primary care setting and to examine the relationship between suicide attempts and a self-reported history of childhood abuse. DESIGN: Cross-sectional sampling via a self-administered survey that included an abuse questionnaire, the Inventory to Diagnose Depression, and questions regarding suicide. SETTING: University medical center family medicine practice. PATIENTS: A convenience sample of patients aged 18 years and older presenting for care. Of the 778 patients approached, 448 patients (58%) consented and returned their surveys. We report only on the 292 surveys (38%) returned with complete information. Subjects were predominantly middle class and white, with a mean age of 37 years. MEASUREMENT AND MAIN RESULTS: Forty-four percent of the patients reported experience of childhood abuse, and 22% reported multiple forms of abuse. Eighteen percent of abused vs 3% of nonabused patients (P = .00001) reported a history of suicide attempts. Being female, younger, and less educated were associated with any abuse. Females reported more sexual abuse; less educated patients, more physical abuse; and younger patients, more physical and sexual abuse and suicide attempts. Odds ratios for suicide attempts, when adjusted by abuse status, were 6.4 for any abuse (95% confidence intervals [CI], 2.4 to 17.6), 4.1 for sexual abuse (95% CI, 1.7 to 9.9), 3.7 for emotional abuse (95% CI, 1.4 to 10.0), and 1.2 for physical abuse (95% CI, 0.5 to 3.1). CONCLUSION: A history of childhood abuse was a common experience in this sample. Patients with a history of abuse, particularly sexual and emotional abuse, are at increased risk of suicidal behavior. To facilitate more appropriate care and treatment, primary care practitioners should question patients regarding a history of abuse.

Determination of khellin in serum by gas chromatography.

A rapid gas chromatographic assay has been developed for the separation and determination of khellin in human serum. Using a DB-17 capillary column and a simple chloroform extraction, khellin and an internal standard, trioxsalen, were separated from endogenous substances without further clean-up. Spiked serum samples in the range 0.11-1.1 micrograms/ml were assayed and a linear calibration curve obtained.

Subtypes of psychiatric inpatient women who have been sexually abused.

The sexual abuse histories of 171 women admitted to a psychiatric inpatient service revealed that 40.3% had a positive history of sexual abuse. The DSM-III diagnoses made on discharge were not related to presence of abuse, age of abuse onset, duration and frequency of abuse, or relationship of the victim to the perpetrator. However, the diagnosis of personality disorder was associated with greater invasiveness of sexual abuse. Cluster analysis of the MMPIs provided by these women revealed four clusters. Membership in the more disturbed cluster was associated with a history of sexual abuse, but not with invasiveness, age of onset, relationship to the perpetrator, or duration and frequency of abuse. The implications of these findings for the role of mitigating factors, such as coping style and adaptation to stress, are discussed.

The discrimination of patient-generated and randomly generated MMPIs.

A discriminant analysis was applied to 34 randomly generated and 34 patient-generated Minnesota Multiphasic Personality Inventory (MMPI) profiles. The discriminant was able to differentiate the two sets at greater than 97% accuracy. A cross validation based on derived unstandardized canonical discriminant functions was carried out on an additional 10 random and 10 patient MMPIs. It attained 95% accuracy. Eight experienced clinical psychologists attained less than 70% accuracy--six of the eight did no better than chance. The importance of including actuarial data in validity judgments was discussed.

The effect of subliminal oedipal and competitive stimulation on dart throwing: another miss.

Silverman and his associates have reported that subliminal presentation of oedipally relevant competitive stimuli can modify dart-throwing performance in male subjects. This study replicated their paradigm, but also examined the effects on performance of nonoedipal competitive stimuli. Our results failed to support Silverman's. Both types of subliminally presented competitive stimuli failed to have any systematic effect on dart-throwing performance.

Capillary gas chromatographic (GC) analysis of nitroglycerin and its denitration products in plasma.

A convenient, specific, and sensitive capillary gas chromatographic (GC) assay for analyzing nanogram concentrations of nitroglycerin and its dinitro- and mononitrometabolites in plasma has been developed. Using a bonded-phase (DB-1) 30-m, 1-micron-thick film capillary column and a 1-m, 5-microns-thick film precolumn, separation of nitroglycerin and all four partially nitrated metabolites was achieved in less than 15 min. On-column injection, electron capture detection, and isothermal operation at 100 degrees C yielded a linear extraction curve over a 300-ng/ml range without any need to concentrate sample extracts. Using methyl t-butyl ether as extraction solvent and o-chloronitrobenzene as internal standard, recoveries from plasma spiked at levels greater than 10 ng/ml approximated 35% for the 1-monometabolite, 40% for the 2-monometabolite, and greater than 90% for all others. The method was employed in a pharmacokinetic study of nitroglycerin administered intravenously to beagle dogs. Plasma samples were collected at various time points and analyzed.

Cross-study comparisons of self-reported alcohol consumption in four clinical groups.

Clinical research on the chronic effects of alcohol has been difficult to evaluate and compare because of the failure by investigators to quantify self-reported alcohol consumption. The authors describe four diverse groups of patients who were treated for alcohol and/or drug abuse. After devising a procedure for comparing the data from these studies, they found that patient self-reports of alcohol consumption may be less distorted than commonly assumed. The present findings are consistent with current research indicating that self-reports of alcohol use are reliable and clinically consistent. The authors also discuss the relationship between neuropsychological impairment and measures of alcohol and drug abuse.

Is phencyclidine (PCP) abuse associated with organic mental impairment?.

The performance of sober (average length of abstinence = 27 months) phencyclidine (PCP) abusers on neuropsychological measures of organicity was compared to that of polydrug users who were not experienced with PCP, and to controls who were not alcohol or drug abusers. Six of 12 PCP users, five of 12 polydrug users, and none of the controls showed neuropsychological impairments. The deficits in PCP users occurred despite negative medical-neurological history, and even though the PCP group abused other drugs previously associated with neuropsychological impairment less than the polydrug group. Deficiencies in abstracting and in perceptual-motor integrative abilities were noted. The results suggest the possibility that PCP abuse might be associated with neuropsychological disturbance which persists for considerable time after PCP use ceases.

Psychopathology and nonmedical drug use: a comparison of patient and nonpatient drug users.

This investigation examined the hypothesis that high-rate drug use is not always related to high levels of psychological discomfort. High-rate drug users who were actively involved in treatment are compared to a group of high rate drug users who had never been in treatment nor did they desire it at the time of the investigation. Although both groups used drugs with high frequency, actual patterns of drug use differed. Comparison of MMPI and CAPPS data suggested that the patients were experiencing significantly more distress than were nonpatients. The data further suggest that the patient group had a poorer premorbid level of adjustment. Based on these data patterns of drug use, possible implications for treatment are discussed.

Organic impairment in polydrug users: risk factors.

In a national collaborative study to assess the neuropsychological status of 151 polydrug users, the Halstead-Reitan Neuropsychological Battery showed deficits in 37% two to three weeks after they entered treatment and in 34% at three-month follow-up. Comparative rates for a group of psychiatric patients were 26% and 27%, and for nonpatients, 8% and 4%. Extensive and intensive use of CNS depressants and opiates correlated positively with neuropsychological deficit. Older, less-educated subjects with adverse medical or developmental histories were more likely to show polydrug-related organic impairment. Although there is some evidence that such impairment is reversible, the condition appears to be of at least intermediate duration and may be long lasting.

Identifying and treating the drug-misusing patient.

The drug misusers whom physicians encounter in private practice are not the stereotypes. Treatment of drug problems is possible on an outpatient basis if physicians are willing to extend their normal role. Overcoming negative feelings toward patients who misuse drugs, employing some basic counseling skills and being aware of the relatively uncomplicated medical procedures involved in therapy can enable the physician to treat certain types of drug misuse in his own office.